This was an unannounced comprehensive inspection that took place on 17 May 2017.

Homefield View provides residential care and support to people with learning disabilities in the further education sector. At the time of our inspection there were five people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People and their relatives told us that they felt safe while they received support from staff at Homefield View. Staff understood their responsibilities to protect people from abuse and avoidable harm. There were procedures in place to manage incidents and accidents.

Risks to people’s well-being had been assessed. Where risks had been identified control measures were in place.

There were enough staff to meet people’s needs. Staff had been checked for their suitability before starting work. Staff received support through an induction and regular supervision. There was training available for staff to update them on safe ways of working and how to meet people’s needs.

People’s equipment was regularly checked and there were plans to keep people safe during significant events such as a fire. The building was well maintained and kept in a safe condition. Evacuation plans had been written for each person, to help support them safely in the event of an emergency.

Where people had medicines that were taken as and when required there were not always guidelines in place for staff to follow. Staff had been trained to administer medicines. Their competency to do this had been checked but had not been reviewed. The registered manager told us that this was to be implemented from the beginning of July 2017.

People chose their own food and drink and were encouraged to maintain a healthy diet. They had access to healthcare services when required to promote their well-being.

People were supported in line with the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). Staff and the registered manager had an understanding of the MCA. We found that people’s capacity to make a specific decision had been considered where necessary. Staff told us that they sought people’s consent before delivering their support.

People received support from staff who showed kindness and compassion. Their dignity and privacy was protected including staff discussing people in a professional and discreet manner. Staff knew people’s communication preferences and used these to support people effectively.

People were involved in decisions about their support. We saw that people’s records were stored safely.

People were supported to develop skills to maintain their independence. People and their relatives had contributed to the planning and review of their support. People had care plans that were centred on them as an individual. Staff knew how to support people based on their preferences and how they wanted to be supported. People took part in activities, hobbies and work or volunteer placements that they enjoyed.

People and their relatives knew how to make a complaint. The provider had a complaints policy in place that was available for people and their relatives. However, some people did not remember where this was found.

People, their relatives and staff felt the service was well managed. The service was led by a registered manager who understood their responsibilities under the Care Quality Commission (Registration) Regulations 2009. Staff felt supported by the registered manager.

Systems were in place which assessed and monitored the quality of the service and identified areas for improvement. People and their relatives were asked for feedback about the service that they had receiv

We inspected Homefield View on 28 July 2016. This was an unannounced inspection. This meant

that the staff and provider did not know that we would be visiting.

Homefield View provides residential care and support for up to five people with learning disabilities in the further education sector. At the time of our inspection there were two people using the service.

We carried out an unannounced comprehensive inspection of this service on 5 October 2015.

A breach of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to a breach of Regulation 11; need for consent of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Homefield View on our website at www.cqc.org.uk.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection we carried out on 5 October 2015 we found the provider had not met the

Regulation where people lacked the capacity to consent to their care and treatment the provider had failed to act in accordance with the provisions of the Mental Capacity Act 2005 (MCA). At this inspection we found the provider had made some of the required improvements.

The registered manager and staff understood their responsibility to ensure people were supported in line with the MCA and Deprivation of Liberty Safeguards (DoLS). We saw that work was under way to increase people’s involvement in decisions about their lives. At the time of our inspection this work had not been completed and as a result capacity assessments and best interest decisions were still outstanding for one person.

Staff had received training and supervision to meet the needs of the people who used the service. Staff told us that they felt supported.

People’s nutrition and hydration needs were met. Staff encouraged healthy lifestyle choices. People’s health needs were met and, where necessary, outside health professionals were contacted for support. People’s health records were being maintained.

People and staff felt that the registered manager was approachable and were confident action would be taken to address any concerns should they have raised them. The provider carried out regular quality checks on the service and had a range of audit systems in place to measure the quality and care delivered so that sustained improvements could be made.

This inspection took place on 5 October 2015 and was unannounced. At the last inspection on 5 September 2013 we asked the provider to take action to make improvements. We asked them to improve practice relating to obtaining people’s consent and acting in accordance with it. Following that inspection the provider sent us an action plan to tell us the improvements they were going to make. We found that although the provider had made some improvements where they had placed a restriction on a person support they had failed to act in accordance with the provisions of the Mental Capacity Act 2005.

Homefield View is a registered care service, providing accommodation, nursing and personal care for up to five people. There were five people using the service at the time of our inspection.

The service is required to have a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. There was a registered manager in post at the time of our inspection.

People felt safe at the service. People took part in house meetings where they discussed health and safety. People were supported to attend an interactive learning session about health and safety.

People were supported with their medicines as prescribed. The service had identified they had surplus controlled drugs in stock but they had no action had been taken to rectify the situation.

People were given choices in day to day decision making. People told us that staff knew and understood their need. People’s privacy was respected. Staff were caring, compassionate and kind. They listened and responded appropriately to people.

Staff went through a robust recruitment process and had an induction period once this had been completed. Staff received training, supervisions and appraisals within their roles.

People were involved in decisions about their care. Care and support plans were detailed and included specific details and guidance for staff to follow.

People had choices about the activities, outings and sessions that they attended. People were also able to make alternative choices and they were supported to do so.

Concerns and complaints that had been raised with the service had been investigated and acted upon. People felt able to raise any concerns they may have.

There was clear vision at the service shared by all of the staff. The values of the service included involvement, independence, dignity, respect, equality and empowerment. We saw the vision statement and mission statement on display within the service.

There were unannounced quality assurance audit visits carried out by the provider to ensure that the service was performing to a good standard.

Internal audits at the service had been carried out. Action had not always been taken by the service when a concern had been identified.

We identified a breach of the regulation where the service had failed to act in accordance with the provisions of the Mental Capacity Act 2005 where they had placed a restriction upon a person’s care and support.

You can see what action we told the provider to take at the back of the full version of the report.

People who used the service were out at their activities whilst we carried out this inspection. We were told that people were working at ‘Barrow Treats’ and ‘Sip and Surf’. During out time inspecting all locations at Homefield College we spoke with a number of people who used the service. All were very positive about their experiences and told us they enjoyed the activities they were engaged in. Our observations showed that the staff team had developed a good rapport with people and that people were comfortable and confident with staff.

We found that people had access to a wide range of community facilities and courses, dependent on their individual needs and choices. These included activities such as learning independent living skills, horticulture, art, drama and swimming. The service had a fully working café known as ‘Barrow Treats’ in a neighbouring village and people were supported to work within the café as part of their timetable of activities. In addition, the service also had an internet café known as ‘Sip and Surf’ in Loughborough. People were encouraged and supported to participate in cleaning, food shopping and meal preparation and we found that people’s independence was promoted by the service.

We looked at the records of two people who used the service and found care plans were detailed and thorough and provided clear guidance to staff about how the persons’ care should be delivered.

However, we found that the service did not have suitable arrangements in place for obtaining people’s consent and acting in accordance with the best interests of the person when they were unable to consent to the care and treatment being provided.

Staff had been appropriately screened to ensure they were suitable to work with vulnerable people. Staff we spoke with demonstrated a good understanding of the needs of people who used the service and treated people with dignity and respect.

Records we looked at were accurate and fit for purpose.

At this house we attended the Wednesday student meeting, where five day and five residential students meet together. We were told that residential students also meet on Sundays to discuss residential matters like menu and activity planning for weekends.

The meeting was facilitated by three staff and held in the residents lounge.

Staff spoke kindly and appropriately and used signing, including when describing the fire evacuation procedures. A simple ice breaker was used at the start of the meeting and students appeared to be familiar with this and all took part willingly and responded appropriately. Students appeared to be smiling and cooperating with the meeting.

We were told by people that staff always treated them with dignity and respect. They (staff) are aware of the need to allow me privacy when I need it. I have that choice anyway.

We are going to play football tonight in Leicester. We go every week and really enjoy it. It keeps us fit as well.

Bedrooms are used only by their occupants and three people showed us their rooms, which contained personalised items and all three people appeared happy with their rooms, one person didn’t want to show us their room and this was respected.

Parents were contacted to hear their views on the care provided at Holmfield view, this is some of their comments:

“Respect and dignity was one of my concerns when he moved. He’d never been away before and it was a quick decision. Hand on heart I can’t fault it. His room is clean and lovely. He has lovely clean clothes available all the time and he is well cared for. We’ve asked to keep him in that area after three years. You can tell by his face, he is always smiling. When he’s not happy he is very withdrawn and won’t speak, we went the weekend before and you can’t shut him up. We took a friend and he couldn’t believe how confident he was in himself.”

“We have no concerns at all about privacy and dignity, when there was a problem they dealt with it straight away and gave me support. Tuesday club – never keen, sometimes doesn’t want to go and then he doesn’t go. They’ve got him swimming, started swimming club, football, shopping. No concerns about safeguarding, I’d tell staff, they’d deal with it. We work together; we are very happy and his confidence has grown. He has work experience at a cafe every week, wears a uniform. We feel proud of our sons progress.”